The drugs do work – but are hard to give up.

Today I heard Sarah Vine – a columnist for the Daily Mail – on the BBC Radio Five Emma Barnett Show.  The Royal College of Psychiatrists has recognised the problems encountered when patients try to come off long-term anti-depressant or anti-anxiety drugs and has called for NICE to provide guidance on the medical, social and psychological support that such patients should be given.  Right now the problem is not recognised and so patients  may be given no support at all.  Sarah Vine was talking to Emma about her own seven year use of anti-depressant and her inability to give them up.

So whatever we think of Sarah’s political views it is to her credit that she has written about this subject form a personal point of view and appeared on the  show.

It seems Sarah’s journey has been typical – she described her symptoms leading to being prescribed the drugs… how they helped her with her problems … and then how, although she reduced her dosage, she had failed on each occasion she had tried to come off the drugs.  She explained that the drugs reduced her mood swings – and while this  removed the major lows it also meant that she was “emotionally anesthetised” – so that she failed to enjoy the things in life that she should – hence her desire to move on from the drugs.  All sounds pretty typical.

So the drugs do work- but the price is that they are hard to come off.  I have previously written about the level of prescribing of such drugs especially to under sixteens.

What grabbed my attention was Emma’s question asking if Sarah would have started out on the anti-depressants if she had known what she knows now.  Sarah said the drugs had really help her … pause… but perhaps knowing what she knows now she might have tried other solutions before resorting to the drugs.

Yet studies have shown that mindfulness based cognitive  therapy  (MBCT) is at least as effective as anti-depressants pills – yet without the longer-term problems it would seem.  At Carina Sciences we would like to investigate at ways to make Rezl available to those who would like to try MBCT before reporting to drugs.  If you are in such apposition then please contract us.  If you are a healthcare or support organisation who would like to engage with us then please  contact us also.


What if you thought you had a full tank of petrol?

I was recently looking at some survey data collected from Generation Z participants.  As you might expect these twenty-somethings were quite open and realistic about their wellbeing  – rating their stress, anxiety and low mood objectively.  What was a surprise was their response when asked to rate their own resilience in contrast with an actual measurement of their resilience… they were way too optimistic.  Over half of them thought their resilience was high – while the tests showed only around one sixth of them had high resilience.  Worse, only about one sixth thought that their resilient was low – yet the actual measurements showed that one third had low resilience.  This suggests that at all levels of resilience they tended to overestimate their capacity to be resilient.

It’s like they’re getting close to the edge without realising just how close they are.

We can think of our reserves of resilience as being like a  kind of “tank of resilience” inside ourselves – and as we encounter challenges this resilience is used up; and then when we are “on empty” we can no longer cope with challenges or setbacks. So if someone is low on resilience and they should face a further set back or challenge – even a very small one – then they can find that they don’t have enough resilience left in the tank and so they may become overwhelmed with anxiety, depression or stress related symptoms.

Now, just to digress a little… the problem with conditions like stress, anxiety and depression is that when people experience such an episode they establish “thought pathways” that spiral downwards… …and then, in the future, when they encounter another “trigger” situation, they slide down the same pathway reinforcing it… and so on, making further episodes more and more likely.  And again, when resilience is low, the trigger doesn’t have to be something big or catastrophic – it could be some relatively minor setback or stressful situation  that triggers thoughts leading to stress symptoms or even anxiety or depression

I expect we all know people who have suddenly developed such symptoms – perhaps experiencing crippling anxiety or feeling they are exhausted or feel too low to get up one morning.  Looking back, in most cases, we can identify a succession of events and situations that have developed over time to consume the available resilience and we may also be able to see how lifestyle has not afforded the opportunity to replenish resilience – yet the sudden onset of disabling symptoms is often a real shock.

So it seems these young adults have a “resilience gauge” telling them they have “plenty in the tank” – yet in reality they are  about to “hit empty”.  The truth is none of us really know how much resilience we have in the tank – yet a gauge that tells us we have plenty may mislead us… until it is too late.

The real danger here is that if we are not aware that we are low on resilience or if we are blind to the possibility that it may run out… then this can cause us make decisions that will actually make things worse:

  • Despite being low on resilience we could opt to take on more responsibility or tasks – i.e. we are “over reaching” what we are capable of at that moment… Jumping from roof to roof is a dangerous game if we overestimate our jumping ability!
  • We fail to find a way to change our workload and/or reframe our pressures and anxieties to that we consume less resilience – a bit like driving more efficiently when we are low on petrol.
  • We do not adopt the lifestyle habits to recharge or rebuild our resilience
  • We do not ask for help and support – as we are unaware of how critical the situation is becoming

So cruising through life with an overinflated estimate of our own resilience can mean that when we hit problems we are shocked at the sudden impact… and by the  realisation that we are unable to proceed as we expected – and this in turn can add to the anxieties around such an episode as we start to question if we are “as good as we thought we were” or if we might lose our career (with all the fiscal implications that this might carry).

To avoid such situations we should all be aware of the drains on our own resilience and of the possibility of our resilience becoming low.  We should take care not to use it too freely and adopt habits to top-up our reserves of resilience on a regular basis. At Carina we are using Rezl to build-up the resilience of our users… and to adopt a mindful approach to life that will be less reliant on the needless consumption of our precious resilience.